Leigh-Allyn Baker sits in a West Hollywood café, slowly stirring whipped cream into her Americano. A working actress with credits like "Will & Grace" and "My Name Is Earl" under her belt, the Kelly Ripa look-alike is six and a half months pregnant and highly conscious of the calories she's about to consume.

"Dieting is still always in the back of my mind," Baker admits. "Really I wanted a latte, but it had too many empty calories."

During the 14 years she has worked in Hollywood, the 35-year-old has endured constant pressure to be movie-star slim. At one audition that called for a woman who felt comfortable being onscreen in a bathing suit, a casting director scoffed at the sight of the 5-foot-2-inch, 110-pound actress in her bikini, rolled her eyes and said, "You think you're thin?"

"If you're an actress, you're always on one diet or another -- it's a way of life," Baker says, sighing. She has suffered through juice-only fasts such as the master cleanse, attempted a raw-food diet and other food-restriction plans, popped phentermine and Prozac and tried drastically slashing calories. When she got pregnant, Baker was elated that she could buy previously off-limit foods. "The first two things I was going to indulge in were a sweet potato and a banana, and I remember thinking, That's really messed up -- it's a big extravagant hurrah to have a banana now?"

Welcome to Los Angeles, perhaps the only place on earth where a piece of fruit is, well, forbidden. Talk to your average Angeleno, and odds are you'll hear a history like Baker's, one riddled with a variety of extreme weight loss attempts: fasts and detoxes, pills and painfully restrictive menus. L.A. women live in the entertainment capital of the world, where beauty standards are unrealistically high and the ultimate compliment is "Omigod, you're so tiny!"

"Most women here are at all times either on a diet, thinking about one, reading about one or hearing about one their friends are on," says Kathy Kaehler, a fitness and food coach in L.A. who works with Julia Roberts and other celebrities. But there's a hitch. Even in this city, if you go on too many diets, your friends will start to think that you are vain, have an eating disorder or are just plain annoying. As a result, women here are -- superficially, anyway -- forswearing dieting and embracing a new euphemism for it: cleansing. Sure, you're still expected to fit into those size 00 jeans, but instead of merely being super skinny, now you're supposed to be skinny and healthy.

The problem for the rest of us is that what happens in Los Angeles never stays in Los Angeles for long. For better or worse, any weight loss craze there will spread, inevitably, to the rest of the country, thanks to the blogs, TV shows, tabloids and tweets that obsessively monitor the bodies of Hollywood celebs. During one week this past January, for example, OK! and two other celebrity weeklies dedicated a total of 15 pages to the hottest Hollywood diet fads, including vegan, Izo Cleanze and master cleanse. When Anne Hathaway went on a 48-hour lemonade detox before the Golden Globes, the news was splashed across the pages of People.

"That's how the ripple effect across the country begins," Kaehler says. "If someone out here is drinking lemon juice and dropping pounds, Lisa in Nebraska will hear about it and start drinking lemon juice."

In reality, however, lemon juice is not a meal, and taken to extremes, cleansing is anything but healthy. Nor is it an effective way to drop pounds for good. To reach this contradictory healthy-skinny ideal, L.A. ladies have developed some disordered techniques that cross old-school self-starvation with New Age mind-body rhetoric. And these techniques will probably land in your town soon -- if they haven't by now.

After all, healthy eating and green living are already fashionable across America, and Los Angeles can lay claim to launching that trend. The city has long had a love affair with its yoga centers, vegetarians, organic-food markets and health food stores, holistic healers and New Age religions. So perhaps it shouldn't be surprising that the latest wave in weight loss in L.A. borrows heavily from the religious tradition of fasting. An ancient ritual, fasting requires devotees to abstain from solid food temporarily in order to purify the body or attain enlightenment. These days, it's considered the absolute quickest means to shed a few pounds with the added benefit of spiritual self-justification.

That's one way of looking of it. Another is that it's simply the latest twist on your garden-variety starvation diet. "The attitude is, I'm going to call it spiritual, like a vision quest," says 31-year-old Mishna Wolff, a 5-foot-11-inch, 140-pound comedienne and the author of the memoir "I'm Down" (St. Martin's Press), who has watched some of her friends suffer through the master cleanse and who has herself tried Atkins, among other more mainstream diets. "There's a subterfuge of health. But it's just vanity."

Fasts Come In Several Varieties

Some L.A. women chug raw fruit and vegetable juices that are delivered regularly to their door by companies such as Izo Cleanze and BluePrintCleanse; others sip tinctures from kits ordered online, like the Blessed Herb's Colon and Internal Cleansing Kits; many whip up their own beverages using "superfood powders" (21 Day Detox) or recipes that call for lemon juice, maple syrup and cayenne pepper (the ever-popular master cleanse).

Although the ingredients vary, the marketing promise is largely the same: Consuming these brews -- and often nothing else -- for anywhere from a few days to a few weeks can help flush out toxins such as food additives, heavy metals, medications, cigarette smoke and other pollutants that disrupt your immune function, liver function, metabolism and digestion; as these toxins leave your body (through increased bowel movements), you'll feel better and perhaps even drop some pounds in the process.

Fashion producer Dawn, for example, did a three-week fast last summer, during which her only sustenance was soups and red and green juices made from superfood powders, vegetables and sometimes berries, complemented by a regimen of detoxifying supplements, digestive enzymes and colonics. The 34-year-old spent hours cooking up broths and blending beverages from daikon radish, kale, cauliflower and other produce. "I made one of mustard greens and garlic that I could not get down," Dawn says. "Do not put garlic in a juice -- I almost vomited."

She contends the goal was to rid her body of toxins built up from excess consumption of junk food and alcohol. "I'd been partying for a month, and stuff needed to get sorted, stuff I wouldn't have lost through working out alone," she says. "It was more about cleansing and being healthy." That said, she's not complaining that she lost 10 pounds. And she repeated the fast this past spring.

In a way, this new health rhetoric is a backlash against the more obviously unhealthy weight loss routes that were popular in the past two decades, including misuse of prescription drugs such as fen-phen (now banned), Clenbuterol (not approved by the FDA for use in humans) and Adderall (a medication typically used to treat attention-deficit/hyperactivity disorder) as well as surgical procedures such as liposuction -- the potential dangers of which have been well documented.

The movement is also a reprieve from wading through the media minefield of ever-changing "good" and "bad" foods because. As dietitian Beth Reardon, the integrative nutritionist at Duke Integrative Medicine in Durham, North Carolina, puts it, "It simplifies the confusing diet world down to one thing: Just drink this. If it's only juice, it has to be good for you!"

But cleanses, detoxes and fasts can lead to some very real physical hazards, especially because they're often done without the supervision of a doctor. "They can really dehydrate you or rob your body of potassium and other electrolytes," says Registered Dietitian Julie Eltman, of Los Angeles. Over time, or even within minutes, electrolyte imbalance can cause heart problems, organ damage and more. Another potential danger: colonics -- enemas intended to "wash out" the intestines -- which frequently go hand in hand with fasting.

Performed regularly, colonics can kill the good bacteria in your intestinal tract that are supposed to protect against infection, compromising your immune system; they also can disrupt nerve and muscle function in the bowel. "I see some people who get their colon cleansed every week and can't go to the bathroom without it," Eltman says.

Potential enema dependence, a weakened immune system, organ failure -- these are high prices to pay for what amounts to only fleeting weight loss, says Reardon, who stresses that however many pounds you lose during a fast or cleanse, they're almost guaranteed to return rapidly. "You initially lose only water weight, then you start breaking down muscle protein," Reardon explains. "It's minimal fat loss." And frequent fasting can slow your metabolism, making it easier to put on pounds later. Ultimately, those who repeatedly fast and cleanse set themselves up for a life of yo-yo dieting, weight regain and the health problems that can come with it, such as heart disease, hypertension and diabetes.

No One Can Fast Forever

At some point, even the most abstemious will need to swap her juices for solid food, a shift that will signal her body to cling to the sudden influx of calories, setting the stage for weight regain. Reinstating solids doesn't mean she'll eat much, though. In fact, many of the most popular Hollywood diets entail food-restriction guidelines that can seem almost as severe as eating nothing at all.

"I call my diet the 'no' diet because there are so many things you can't have," says Mary Louise, a 48-year-old Hollywood screenwriter. When she's not fasting (which she does at every season change for two to three days), Mary Louise adheres to a version of the candida diet, which consists mostly of brown rice, green vegetables and organic beans and forbids all dairy, breads and sugar. "Before, I was really sick and I didn't know why. I was lethargic; I couldn't get out of bed," she says. On this plan, she says she feels energetic and clearheaded. She also has shed nearly 30 pounds. "But in the beginning, I was down to only five foods I could eat."

That sounds almost lavish in comparison with the recommendations of popular plans by Beverly Hills physician Dr. Howard Flaks, who advises eating only 800 to 1,000 calories a day under weekly medical monitoring. According to a patient we spoke with, her plan consisted of 7 ounces each of protein and vegetables, two pieces of fruit and a handful of crackers, to be washed down with at least 10 glasses of water. By contrast, Reardon and other registered dietitians say women on diets should consume at least 1,200 to 1,500 calories daily. "It's a shock, the first week, a real shock," says the Dr. Flaks true believer, who lost more than 30 pounds with his guidance. "But you realize how addicted you are to the idea of having plentiful food."

Without a doctor's surveillance (and possibly even with it), extreme plans that radically restrict calories or ban vital foods such as carbohydrates altogether could have life-threatening consequences. Take the case of Aimee Popovich, a 39-year-old Los Angeles homemaker and mother who went on a raw-food diet, eating only uncooked fruit, vegetables and nuts and started drinking a lot of water. At first, she says she believed it delivered all sorts of health benefits, including a stronger immune system and less difficult childbirth. "I felt fantastic for a year and a half, and it was easy -- I didn't have to spend time standing over the stove; I could just grab something raw and go," Popovich says. "But then I realized something was wrong: I had too much anxiety and a nagging problem with urgent urination." Yet she stuck with the diet for five months more, until one day, while laid up in bed feeling sick and dizzy, she had a seizure and passed out. Her husband called 911. Popovich seized again, vomited and stopped breathing. Fortunately, her husband knew CPR and was able to get her breathing again by the time the paramedics arrived. Still in and out of consciousness, Popovich had a third seizure on the ride to the hospital.

When she fully came to two days later, doctors told Popovich she was undernourished, devoid of vital minerals and suffering from kidney failure and brain swelling due to a severe electrolyte imbalance and hyponatremia, a condition caused by excess water in the blood, which can result in dangerously low blood levels of sodium. She spent a week in the hospital receiving saline and antidiuretic hormones and following a diet high in protein and salt and low in water. She has been consulting with a nutritionist ever since and, after nearly a year, finally feels healthy. "I'm not eating exclusively raw anymore, but it still makes up 40 to 60 percent of my diet," Popovich says. "I think there are a lot of benefits to it. Some people have been very successful on the raw diet for years and years, so it can work."

What cleanse dieters lack in food they often try to make up for with supplements, herbs, teas and other products in the hopes of maximizing their slim-down. According to Hollywood trainers and nutritionists, the most popular natural weight loss supplements include L-carnitine, an amino acid that allegedly speeds fat metabolism, and CM3 Alginate, a seaweed formulation manufactured in Europe that supposedly expands in the stomach to make you feel full and thus eat less.

And women throughout Los Angeles are stocking up on detox teas (mild herbal laxatives) and plant extracts like Hoodia (believed to be an appetite suppressant), whose benefits remain unproven -- but they're attracted to the word natural that's slapped on the package.

"In the past, people were looking for something that made them not eat at all, like fen-phen; now they're looking for something that naturally assists them in making dietary changes without the jitters of ephedra," says Valerie Waters, a personal trainer in L.A., who has worked with Jennifer Garner and Jessica Biel and endorses the CUUR Weight Loss System, a diet and exercise program that includes taking an herbal supplement that purportedly revs up metabolism.

Before you hightail it to your local supplement store for any slimming products, consider this fact: Many trainers and nutritionists who recommend supplements lack the R.D. or registered dietitian, after their name that qualifies them to do so, warns Dr. Arthur Frank, medical director of the George Washington University Weight Management Program in Washington, D.C.

"These supplements probably have no value -- the best you can hope for is that they won't harm you," he says. Alarmingly, the FDA recently discovered that dozens of common weight loss supplements are full of hidden prescription drugs that can have serious side effects. For instance, Pro-Slim Plus, Perfect Slim and 66 others were found to contain sibutramine, the appetite-suppressing ingredient in the perscription diet drug Meridia, which in high doses can raise blood pressure and cause heart palpitations and seizures. "Even if a supplement has some potentially useful botanical product in it, it has probably not been formally evaluated or undergone clinical trials, and no one knows about proper dosage or side effects," Frank explains. "The fact that it's natural doesn't mean it's useful or safe."

Dieting Now Has a Social Stigma

Safe or not, the healthy-skinny movement is fueled by women no longer feeling they have to tell their friends they're on a diet; instead, they're simply following a "health plan." This idea goes down particularly well in Hollywood, a town where celebrities profess their love for french fries while secretly purging to stay wafer-thin, where everyone pretends to be inherently slim -- and where half the women interviewed for this article begged to remain anonymous because they didn't want anyone to think they had weight issues. Admitting you're on a diet these days somehow means you're weak.

"It's totally uncool in L.A. to talk about your diet -- that makes you a bitchy, bratty, vain woman," says Julie, a 33-year-old television writer. "It's an impossible standard: We're not supposed to think, talk or worry about it, but we're still supposed to look perfect all the time." After trying low-carb diets, South Beach and "anything Oprah told me to do," Julie (who is 5 feet 7 inches and weighs 138 pounds) finally settled on veganism after reading the diet bible Skinny Bitch, which advocates veganism as an eco-friendly way to shed pounds. "In television writing, which is such a male-dominated industry, women have to be liked and respected by men in order to get and keep jobs," she says. "So you can't seem like a frivolous, stupid, typical girl, the kind who's obsessed with her weight."

Packaging a new restrictive diet as a health regime also keeps concerned friends from meddling. As Carly Milne, a 33-year-old journalist in L.A. and former master cleanser, puts it, "If I were to tell my girlfriends I was going on a diet to lose weight, they'd all say, 'Love yourself for who you are; you look fabulous!' But if I say I'm on a quest to get healthy, everyone is really supportive. It's like you're taking care of yourself, instead of beating up on yourself for not being perfect."

The disconnect between this New Age rhetoric and the truth of what many women are actually doing -- often, using socially acceptable quasi-anorexia to starve themselves skinny -- can wreak psychological havoc. "My outside message was 'I'm cleansing; I'm detoxing; I'm getting healthy,'" Milne says. "Inside it was, 'I'm fat; I need to be prettier and fit into a smaller size.' At the time, I was totally able to self-justify. I was working in PR and dealing with a lot of media, and I felt I had to have a particular look in order to be accepted or listened to. So I made it all about work, that I wouldn't be successful unless I was skinnier, and that I had to do the cleanse. Looking back, I realize how destructive I was being."